Metastatic Melanoma in Lymph Node

This 6.5-centimeter mass was removed from the axilla of a middle-aged
woman, who was a longtime resident of a developmental center for the
severely disabled. She was unable to give any history, but there was no
medical record of a primary melanoma, and we were unable to find any
biopsy scars at the time of surgery. The dark brown color of the cut
surface provided a clue to the diagnosis, an unusual finding in
metastatic melanomas, which are more typically amelanotic (like the
upper right segment of this specimen). Pigment was easily demonstrated
in the tumor cells at frozen section, allowing a definitive diagnosis
intraoperatively.